单克隆抗体治疗对内源性 SARS-CoV-2 抗体应答的影响。
Effect of monoclonal antibody therapy on the endogenous SARS-CoV-2 antibody response.
机构信息
Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA; Division of Hospital Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
Pharmacy Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA.
出版信息
Clin Immunol. 2022 Mar;236:108959. doi: 10.1016/j.clim.2022.108959. Epub 2022 Feb 24.
Monoclonal antibody treatment of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been widely implemented. Effects of treatment on the endogenous primary humoral response to the virus are unknown. A retrospective cohort study performed at a Veterans Health Administration medical center compared serologic responses of treated and untreated COVID-19 patients at high risk for severe outcomes. Three anti-viral spike protein IgG monoclonal treatments were used during the study period, 1) bamlanivimab, 2) casirivimab with imdevimab, and 3) bamlanivimab with etesevimab. Data were analyzed at acute (0-9 days), seroconversion (10-19 days), and maximum antibody (20-39 days) stages. SARS-Cov-2 infection induced a dynamic primary humoral response with anti-spike IgM and anti-nucleocapsid IgG seroconversion occurring after 9 days with maximum serologic indices achieved by 20-39 days. All monoclonal antibody treatments suppressed the endogenous anti-spike IgM response by 85-90% with minor effect on the anti-nucleocapsid response. Thus, passive immunization therapy may cause immunologic interference.
单克隆抗体治疗严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)感染已广泛实施。治疗对病毒内源性初级体液免疫反应的影响尚不清楚。在退伍军人健康管理局医疗中心进行的一项回顾性队列研究比较了高风险发生严重结局的 COVID-19 患者的治疗和未治疗患者的血清学反应。在研究期间使用了三种抗病毒刺突蛋白 IgG 单克隆治疗药物,1)巴姆单抗,2)卡西米单抗联合伊德维单抗,3)巴姆单抗联合埃特司韦单抗。数据在急性(0-9 天)、血清转化(10-19 天)和最大抗体(20-39 天)阶段进行分析。SARS-CoV-2 感染诱导了一种动态的初级体液免疫反应,抗刺突 IgM 和抗核衣壳 IgG 在 9 天后发生血清转化,最大血清学指标在 20-39 天达到。所有单克隆抗体治疗均抑制了内源性抗刺突 IgM 反应,抑制率为 85%-90%,对抗核衣壳反应的影响较小。因此,被动免疫疗法可能会引起免疫干扰。